Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit #: ELR201300096
T [ GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/01/2013
Parcel: 2S102AB01800
Jurisdiction: Tigard
Site address: 9460 SW TIGARD ST
Project: Primative Enterprises Subdivision:RTH TIGARDVILLE ADDITION, AMENC Lot: 56
Project Description: (1) low voltage for Data/Telecommunications
Contractor: BRIDGETOWN ELECTRIC Owner: WRAN LLC
5701 N LOMBARD ST 9460 SW TIGARD ST
PORTLAND, OR 97203 -4113 TIGARD, OR 97223
PHONE: 503 - 621 -7122 PHONE:
FAX: 503 - 621 -7123
FEES
Description Date Amount
Specifics: Restricted Energy Permit 05/01/2013 $75.00
12% State Surcharge - Electrical 05/01/2013 $9.00
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: Y Fire Alarm: N
HVAC: N Instrumentation: N
Intercom /Paging: N Landscape /Irrigation: N
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N Total $84.00
Other Desc: Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952-001-0090. You may � obtain a of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: � JC � �N IiC.Y K tit f Permittee Signature: 0kJ P(LIc# I /O/l
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE: Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each Inspection.
Apr 30 2013 1:47PM Bridgetown Electric 503 -821 -7123 page 2
Electrical Permit Application° • E�D
City of Tigard
13125 SW Hall Blvd., Reca±ved r r 3 S� t�► .► o11F1r3 -flC�O 9+lr
"Tigard. OR 97223 IaatcrNV,
Ell
-
(t`t ° 3 0 ? 013 �.,.:�.,
Phone: S03.639.4171 Fax 503.598.1960' I>utali Other Permit
Inspection Linc: 503.639.4175 �! truce Ready ay 0 Sae 2 ter
Internet: www.tigard-or.gov Cl OF TIGARD N. Mwlnxt. ' • % Soppk tsl htaesatiaa
u t3 DIVISION yj
❑ New construction ( � Additioa/alteration/.•lo:cment Maio.
ea ekeketilcan (� (las winnow chokedbelow):
❑ Demolition 1 O Service or seeder • • tempi pi or more D Buidisg OM (tree storks.
.. Usher. .,_.___ __ ,._ __ where the sank , .. Pauli ceases( Q 66aieas sod t ,i:. a .. exceeds 10.000 a i, a • at 150 sosober's' ❑ Rost *S bttt'Idta' ga.
•
t Ices to Srmlz 14.000 ❑ Comnape ial-we agricultural
and 2•
❑ 1- afamiy fhhtrlli p C.aahittencial/ind , ai 0 Accessory building amps for all other i ...ntmions buildings.
❑ Multi - family 0 Manlier builder ❑ Other: 0 Fire pump ❑ iaseallatioa of /5 KVA or
t ` : no* ',wor xy sew (arses separately deriand system
❑ Adldition anew a or load of ❑ - A ",'H",'I -2°. - 14 ",
/3 3 +� 9 ii ` 0 51 I0011P or mnra. eoe ey.
Job no.: 1 7 lob site address: i t T
❑ Sot or more reside mil nulls. ❑ Raereatioost %Miele
C ily/StattJ /,lP: "rt /� t- ❑ Health -utte faciii ❑ Simply anitaae for man than
5 0. 04 O Q a7 `# P 7 600 ,site ttaemaal
ta�aedaus
Suite/bldg. /apt.no.: S,(. 1 t./1 Project name: 1.,"0.4.1v4.. +f� r, �
t ❑sieaorfewer a awr
, &
Cross to ' site: ,
Cros �
job LL "1I11■t ttt6 "->tlllttl:Mt
a. —; .._- --.... Ne* sea Bestial or Nttili- kosily dwelling snit.
Includes attached ; .
Subdivision: I I AN no.: I sq. It. of less 168.54
• �..._.._......_M_._.�..__._.... _._...., ... .(kill Fa adtl•1500st1, tt. , potion III � �
Tax map/parccl no,: l.imitedcnt. re •• 7500
t 1 ` 060 above s9. R
n- o► residential {wiISJ fatally 75
V C'•GW : !2_ ',tr " ere_ ._., lP 4 c, D. 4o...... ` .ern w. +. " . 1i.
pp p I ........ _....
Limited
er ter molt NteradoiN nad/er relocation
S *�o`c-c `Foy '(�Vrt-4;.4- �6- ' _ _.__ — 200 amps or less 10070 2
1 ❑ TENANT . 201 amps to 400 133.56
401 amps to 600 a 200,34 2
Name:
+. , .... _ . 601 amps to 1.011D onion III 301.04
Address: Over 1,000 amps or • 55_2. II
-__- Temporary aervi or feeders inataned**, elteratioa, *mum
relocation
Phone: ( ) T Iia.: ( ) - man amps or Wu 59.36 1
Owner installation: This installation is being made on property that I own whit.* is not 201 amps to 400 m"`_ 125'0a `
intended for sale, rent, nt, or exchange, according to ORS 447, 449., 671); and 701- 401 amps to 599 alma; 16$.34 2
thvner I
y nature: f
_ _.__, __ • Date: A. I'M for Mmtcbc' : u: with
__�.., . > .,..._.... ebov cservice or - • a;
0 `{�1ii t branch t ire 7.42
1 �
. Business name: I R. Fee for branch cl . • withow
...... _ . smv or feede r f. first
Contact name: branch circuit 56.I IS
...1 - Lich
Address: I
Manama - i
...:.. .__...,... M el or kedeT not ,
Lath menu r. .1 - • orimodular ,
City/Stale/ZIP:
_ duelling, service and/or feeder III
Phonic: ( ) 1 Fax: ( 1 Reconnect only III 67.84 2
_. _... _ .. ...... _.. _... - ...._._._ __ Pub or irrigation circle 67.14 3
E-mail:
Signor tarditne tightinl 67.84 2
Shoal circuit s) or Waited.rnera
'hilliness name: . E ['(T ► panel, alteration. or negation. - 2
{ e �V Place atldltiaa*l inspection over allowable In tae of aloe above
Address: S7 0/ / V . 1 - 0 S ri2i T Additional inspection 11 hr min) 66.25/ hr
City/StatN/IP : a ,31> g1103 ,ray 1 ._ - _ � ._.__� InvcatigAticn (I he 66.25! ter
... ... , / Industrial plot (1 hr ) 71.111/ hr
a te ev�
Phone: ( 4' y 1 w 1 12 2. Fax: ( 4
) 1 1/23 _.... btspcdiens for wil101n a � ��
• ,. ,� '�'�err� 90.00t Iv
CX.:B Iris:.. 1 03 8:4 1 Electrical Lie.: f , , , bra ' i ,' Suprir. l .ic...4 1 7 7% �` I_ , .,, , .., . lkANIIIN
Sups . Electrician d>Crttuurr, raWdtd, f r' e ;�,!+,F t � ' f _.- . —_..__ 1Id11aaW.
Plan : iew.(25lfror • , itke): iiiiiiiill
Print nark:, 5 e
, yeA, .-, :., 1 Dot_ c a e: 14/c , ' State •
u.2% of.penut fee): - ••
__ - .� _ !_ o ff ... _.._.�
Authorised signature: TOT/44114010T PEE: C o 14 -
•chi+ permit rooms espilralta " iliol armed whirls Isla
Print name; Dale: • it Mon Mee rtide imonapitle.
. _, . ,_..- ........_,_. - ' Nurnl><rofieppedti• attlowedporpetsnk •
n' i turdieytFenaxflfI A'- PmarApp doe 07ro,lsn ; 441HS1S nil IJU4'cOAVwRn 1
I
•
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9460 SW TIGARD ST, TIGARD, OR, 97223
Commercial - Electricial Limited Energy
199 Electrical final
05/09/2013 00:00
ELR2013-00096
PASS - No C of O
Violation Summary:
Inspector Contractor